Discoid lupus scars, and sunlight is a well-recognised trigger for new and active lesions. Daily broad-spectrum sunscreen and sun avoidance are part of treatment, not an optional extra, alongside topical or intralesional steroids and antimalarials when needed.
Because a minority of patients go on to systemic lupus, routine review should include simple questions and tests rather than only the skin: joint pain, mouth ulcers, fatigue, a blood count and urinalysis.
- Advise daily broad-spectrum sunscreen and protective clothing for everyone with discoid lupus.
- Ask about smoking, which is linked to more active cutaneous lupus and poorer antimalarial response.
- At review, ask about joints, mouth ulcers and fatigue, and check a blood count and urinalysis.
- Treat active lesions promptly to limit permanent scarring and hair loss.
Why it matters
Scarring is permanent, and systemic progression is easy to miss at a skin-only visit.
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